Abstract
A 58-year-old man with gastric carcinoma was referred to our hospital for further examination and treatment. Esophagogastroduodenoscopy showed a depressed lesion measuring approximately 25 mm in diameter below the esophagogastric junction (EGJ) , which was slightly elevated proximally. Pathological examination of biopsy specimens revealed well-differentiated adenocarcinoma. No evidence of atrophy was detected in the background gastric mucosa, and serological examination showed negative results for Helicobacter pylori infection. Although we assumed submucosal invasion in the proximal part, the patient opted for endoscopic treatment. No metastases were detected by computed tomography ; therefore, endoscopic submucosal dissection was performed. Histopathological examination of the resected specimen revealed well- to moderately differentiated adenocarcinoma (Type 0-IIc, 20×27 mm, pT1b1, ly0, v0, pHM0, pVM0) . The proximal part was found to be due to an esophageal retention cyst, and there was no evidence of submucosal invasion. Histopathology ruled out Barrett’s esophagus, and we diagnosed EGJ carcinoma. With a decrease in the incidence of H. pylori infection, the detection rate of lesions such as EGJ cancer may be expected to increase. However, such lesions are likely to be overlooked; thus, careful examination is required even in H. pylori-negative patients.
